Tag: mental health

Yesterday, as I went to work, news broke that actor and comedian Robin Williams had been found dead in his flat in a suspected suicide. Today, as I woke up, the UK newspaper front pages were being released on Twitter.

The Sun and the Metro have decided to go with details of how Robin Williams killed himself, while the Mail and the Mirror focussed on the reasons why. (The Mail Online goes into excruciating detail on the methods Williams used, but does so in the body copy of an article.) All four are cheerfully ignoring the Samaritan’s guidelines on media reporting of suicide, which cite evidence that “Vulnerable individuals may be influenced to engage in imitative behaviours by reports of suicide, particularly if the coverage is extensive, prominent, sensationalist and/or explicitly describes the method of suicide.”

This is happening in the UK, where funding is being stripped from already-stretched mental health services at the same time as punitive welfare policies strip money from the poorest and force severely unwell people to attempt to work despite disabilities that make it impossible for them to do so safely. A population that is already incredibly vulnerable is being made more so by lack of access to treatment and to funds. The UK is currently in the grip of an acute mental health crisis. This context is important.

The reason the media isn’t supposed to talk about methods used is because that knowledge can turn someone who is passively suicidal into someone with an active plan. Knowing the distances dropped, the ligatures used, the medication taken, the blades employed, all of these things can give a suicidal person the knowledge of how to actually do the deed, how to go about taking their thoughts from the realm of the hypothetical into the realm of the real.

Of course, if they want, they can just Google that information, but that requires an act of will on their part; there’s a barrier that acts as another check, a moment where someone might look at what they are doing and consider other possibilities. Google also places helpline numbers prominently in its search results, which is more than some media manages in its reporting. (Side note: there is a story to be written about what changed in September 2010.) Plastering that knowledge all over every newspaper someone sees on their walk to work, in their local supermarket, in their train carriage, negates that barrier completely. It says: here is how you successfully kill yourself.

Even if they don’t contain step-by-step instructions on how to kill yourself, a wall of front pages tying suicide to a specific cause lends justification to a suicidal person’s internal logic that says suicide is a rational response. Suicidal thoughts are, for many people, a temporary problem; distracting yourself from them is a valid and sensible response, and sometimes the only way to stop yourself acting on them. It’s hard to maintain that distraction when a celebrity dies in this way; it’s harder still when the media seems to buy into the idea that money troubles, for example, are a reason for suicide. There is, inevitably, a search for meaning, and a desire to rationalise what’s happened, but reductionist and intrusive stories hurt the families of those who have died by telling them, in effect, that there might have been something they could have changed. They also tell suicidal readers that there are good reasons to die, sometimes; they reinforce the grim logic of acute depression. You can do this even with the most gentle, most well-meaning attempts to memorialise someone’s life.

The flip side of the media response is a slew of articles tying Robin Williams’ comedic genius inextricably to his depression and struggles with addiction. But he was brilliant despite his mental illness, not because of it. We search desperately in cases like this for a spark of hope, a positive spin, and find it in “divine madness”: the idea that his genius could only exist alongside his sadness. But without his brilliance, the madness would remain, and without his madness, the brilliance might have shone so much more brightly. You can be a genius without being depressed, and generally those without major chronic illnesses get a lot more done and have longer lives. There is a strange ambiguity about the “divine madness” narrative that feeds in, at lower levels, to anxieties about getting treatment. What if, without the depression, I am no longer me? What if I lose my creative spark? What if I lose the last of what makes life possible?

But the onus is still on us, the mentally ill, to seek treatment despite our (not always unfounded) fears that it might not work and might even harm us. We are told to talk about depression more, when talking is just about the last thing a depressed person wants to or feels able to do, and when most people aren’t interested in listening. We’re told to seek help, when in reality that help is often unavailable. The last time I needed serious therapy, it took 12 months for an appointment to become available; that was before the current crisis. I cannot imagine I would be able to negotiate the barriers to NHS assistance if I were suicidal in London this morning, even in my position of relative wealth, insight and access. But it’s entirely plausible that Robin Williams did manage to get the help he needed, and it just wasn’t enough. It isn’t enough for a lot of people. A lot of people die despite excellent care. We need more research, we need more treatment options, we need a revolution in mental healthcare. What we get are front pages that make our illnesses worse.

Fundamentally, the media doesn’t care about the guidelines. It doesn’t care about the people they’re meant to protect. Mentally ill people who die come in two types: the talented and brilliant, for whom death is an inevitable part of their brilliance, and the poor and underprivileged, whose deaths are irrelevant except where they interact with an existing story. The media doesn’t care about our deaths, unless we’re famous, and then it will pore over every gruesome detail regardless of how that might affect those of us still living, still struggling, still reading the news and still fighting for hope every day. What does it matter, after all, if a few more people succeed in killing themselves in the next few weeks? They were depressed. There was nothing anyone could have done.

In news-that-ought-to-be-satire-but-isn’t, the AV Club reports, via New Scientist, that Facebook has been manipulating users’ feeds in order to test whether they can manipulate their emotions. 689,003 users, to be precise.

The full paper is here, and makes for interesting reading. The researchers found that, yes, emotional states are contagious across networks, even if you’re only seeing someone typing something and not interacting with them face-to-face. They also found that people who don’t see emotional words are less expressive – a “withdrawal effect”.

Where things get rather concerning is the part where Facebook didn’t bother telling any of its test subjects that they were being tested. The US has a few regulations governing clinical research that make clear informed consent must be given by human test subjects. Informed consent requires subjects to know that research is occurring, be given a description of the risks involved, and have the option to refuse to participate without being penalised. None of these things were available to the anonymous people involved in the study.

As it happens, I have to use Facebook for work. I also happen to have a chronic depressive disorder.

It would be interesting to know whether Facebook picked me for their experiment. It’d certainly be interesting to know whether they screened for mental health issues, and how they justified the lack of informed consent about the risks involved, given they had no way to screen out those with psychiatric and psychological disorders that might be exacerbated by emotional manipulations, however tangential or small.

The researchers chose to manipulate the news feed in order to remove or amplify emotional content, rather than by observing the effect of that content after the fact. There’s an argument here that Facebook manipulates the news feed all the time anyway, therefore this is justifiable – but unless Facebook is routinely A/B testing on its users’ happiness and emotional wellbeing, the two things are not equivalent. Testing where you click is different to testing what you feel. A 0.02% increase in video watch rates is not the same as a 0.02% increase in emotionally negative statements. One of these things has the potential for harm.

The effect the researchers found, in the end, was very small. That goes some way towards explaining their huge sample size: the actual contagion effect of negativity or positivity on any one individual is so tiny that it’s statistically significant only across a massive pool of people.

But we know that only because they did the research. What if the effect had been larger? What if the effect on the general population was small, but individuals with certain characteristics – perhaps, say, those with chronic depressive disorders – experienced much larger effects? At what point would the researchers have decided it would be a good idea to tell people, after the fact, that they had been deliberately harmed?

A lot’s been said about the killing of six people by a man, possibly mentally ill, certainly with a gun, certainly with a deep hatred of women and a deep anger over what he sees as their rejection. I don’t want to go over old ground; here are a fewexcellentpieces that are worth reading on this whole sorry mess.

What is worth saying, though, and what I’ve not seen said elsewhere, is a little about the nature of madness, and how it might apply here. It is pointless to go over whether the killer had a diagnosis, as that diagnosis cannot hope to explain his actions, any more than a diagnosis of OCD can hope to explain why a particular person might scrub their hands raw rather than compulsively locking doors, or a diagnosis of schizophrenia can explain why a person believes they have magical powers that control the weather rather than believing the NSA is stalking their every move. The differences have their genesis outside a person’s brain chemistry, in their society, their upbringing, their present situations, the elements of their obsessions that are permitted space to grow unchecked.

The specifics of madness are not so closely linked to diagnoses as most people would like to believe. One cannot simply write off all delusions as madness, nor all violence, nor even all shooting sprees, because madness is not a sufficient explanation. Even if we know for certain that a shooter is diagnosed as mentally ill, what we do not necessarily know – and what we must ask – is why their illness has taken that particular form. Why women? Why people of colour? Why sex? Why entitlement?

Madness is born in sanity. It is born from society. It does not spring, fully formed, from the brain in isolation: it is defined socially, it is constructed socially, it is through the establishment of social norms that abnormality is recognised and regulated. Mental illnesses grow like weeds; the nature of the weed is dependent on the soil, the light, the water. Sometimes the only thing that makes a weed a weed is the fact it is appearing in a neatly manicured bed of some other flower.

The California killer’s mental illness was not madness, when it was limited to posting on forums about how much he hated women. It was not madness when he spoke online about his fantasies. It was not madness when he suggested women deserved to die for rejecting him. If he had only killed one woman, an ex-girlfriend or a prospective partner who said no, a great deal of evidence suggests it would still not be judged as madness; this happens every day, and society rarely says it is insane.

Sanity and insanity are two ends of a spectrum, not distinct states, and there is a great deal in the middle that is murky. It is frightening that such hatred, such aggression towards women, such entitlement and anger, is only murky.

Why does society call angry, threatening young misogynists mad only after they have pulled the trigger?

I remember where I was when Kurt Cobain died. That’s probably a little unusual for someone of my age, because I was ten years old at the time. I didn’t yet really listen to much music, but I was on a family holiday with cousins a few years older than me, in Majorca, in a wide sprawling villa with ceramic tiled floors and a walk-in pantry in which, one exciting day, we found a centipede.

A huge thunderstorm woke me up scratching in the middle of the night – surprise and eczema are not good friends at the age of ten – and I ripped my arms from elbow to wrist in one half-asleep double-scratch movement, and I couldn’t go back in the swimming pool after that. Instead I sat outdoors and read a book of short horror stories – not Goosebumps but in a similar vein – three times in a week because I’d not brought enough books with me. There was one story in particular about a girl who found a cursed ring that forced her to hear the exact thoughts of everyone around her, including the people who secretly hated her, and it eventually drove her mad.

My cousins were old enough to watch MTV in the cool room where the pool table was, and it was through them that I learned that Kurt Cobain was the lead singer of a band called Nirvana, who were pretty good, and that he’d died. I also learned about Beavis and Butthead. It was a pretty good spring holiday.

Somewhere around two years later I bought my first album. It was the Spawn soundtrack. I hadn’t seen the film but the cover looked really, really cool and it had bands I’d heard of making music with bands I hadn’t. I think on some level I figured that if every song was a remix, every song had two bands, so I’d get twice as much value for money. After that, From The Muddy Banks Of The Wishkah was maybe my second or third purchase. I picked it up from a second-hand record store in York where my cousins lived. I was trying to be cool. Of course I was. I was 12.

I fell in love with that album. I listened to it over and over, poring over the lyrics in the CD insert, trying to understand how you took words like that and turned them into that sound: that rawness, that energy, that emotion. I started all backwards with Nirvana, so I was never really a Nevermind girl; eventually, when I’d picked up every album and gotten my friends to trade me tapes of bootleg tracks and B-sides, it was Bleach I loved the best. In Utero was too raw, too sad, too strange, too close to home. Nevermind was too popular, maybe, or perhaps just not energetic enough. I could jump around to Bleach. I could put on my massive 90s jeans and my skater chain, or my black miniskirt and my striped tights, and dance to it.

When I went to hospital my parents brought in CDs for me to listen to. They gave me a MiniDisc player for Christmas, the Christmas I spent on the adult psych ward, and I copied albums across to it so I could listen to them when I couldn’t sleep. I listened to a lot of In Utero that year. I put up a poster of Kurt Cobain on the noticeboard next to my bed, that one of him in jeans and a grey sweater with a gun in his hand, where he’s smiling. The music therapist taught me some basic chords on the guitar and I learned to play Polly, along with the chorus of “Why Does It Always Rain On Me” by Travis, because it used a lot of the same chords and it was always playing on the radio we had on in the dining room during most meals, to make the whole thing less weird for the anorexic patients.

When I was 14 or 15, I bought a huge long-sleeved T-shirt with the Nirvana acid smiley on the front and a slogan on the back: FLOWER SNIFFIN KITTY PETTIN BABY KISSIN ROCK N ROLL WHORES. I bought a dark colour to hide the blood, knowing there would be blood. These days, sometimes Grant wears it around the house, and I go short-sleeved.

I don’t listen to a lot of music these days. Sometime in my first or second year at university, about the time I stopped self-harming, I also stopped finding new music, and slowed down on listening to the things I’d always loved. Something about music rubs me raw, opens me up too much. I get emotional in ways that aren’t always comfortable, when the emotions come from the music – or from the past. When I made Detritus last year, I hadn’t listened to Nirvana specifically – deliberately, in the non-Spotify-random-playlist way where you actually listen to the music – in perhaps two years. I named each act after a Nirvana song, because that’s what was playing in my head when I was writing.

This is an interesting thing: a New Review post that looks at the history and present of trigger warnings, and how they’ve moved out of communities online and into public life and spaces. If you don’t know what a trigger warning is, it’s essentially a note indicating that you might be about to encounter something upsetting, something that could negatively affect your psychological wellbeing; they’ve grown out of supportive communities in which people needed to carefully negotiate conversations about subjects that need to be spoken about, but that also could prove detrimental to readers’ health. The roots, however, aren’t quite as simple as the New Review piece paints it them:

Initially, trigger warnings were used in self-help and feminist forums to help readers who might have post traumatic stress disorder to avoid graphic content that might cause painful memories, flashbacks, or panic attacks. Some websites, like Bodies Under Siege, a self-injury support message board, developed systems of adding abbreviated topic tags—from SI (self injury) to ED (eating disorders)—to particularly explicit posts. As the Internet grew, warnings became more popular, and critics began to question their use.

It’s rare to see an article on trigger warnings mentioning Bodies Under Siege, despite its early adoption of warnings as a way for its users to safeguard themselves. It’s a shame, then, that the piece skips over the ways trigger warnings were used there in the late 90s, when I was an active user. They were not a way for users with PTSD specifically to avoid harm; they were for all users – including those without mental health issues – to avoid subjects that could trigger them into unsafe behaviour, or that they didn’t have the mental energy to tackle. They were carefully considered and carefully enforced alongside a list of verboten things that mods would delete on sight: discussions of weights, calorie counts, numbers of self-inflicted wounds, images. Those things were not done lightly. Bodies Under Siege was a community of vulnerable people struggling with mental illnesses of various degrees, and it was built entirely around recovery and support. Trigger warnings and removal of things that could prompt ‘competitive’ behaviour were not courtesies. They were absolutely integral to the community’s existence.

I used a couple of other forums for people who self-harmed, in my teens. BUS was the one that did not make me worse. There’s a direct analogy between one of those forums and pro-anorexia communities; at its worst, it provided encouragement to hurt yourself, and at best it was simply reinforcing the behaviour, a reassurance that self-injury was an OK thing to do. It was not a healthy space. The second, though, tried to be about recovery, but allowed images and discussions of self-injury particulars. It was a deeply conflicted space, as a result: if you were feeling OK, you could quite easily end up feeling worse after a visit. If you were already feeling bad, you went there knowing it would most likely spiral downwards, playing Russian roulette with your feelings. You would, almost without doubt, stumble across something that would likely tip you from ‘maybe I could hurt myself’ into the act.

Trigger warnings on BUS made it safe from that concern. It was a place you could go while feeling awful to try to be strong. It had thread after thread of distraction games, little time-wasting things you could do to stave off the need to self-injure. It had questionnaires to fill in before you did it, drawn up by users and psych professionals, and questionnaires to fill in afterwards. It had resources for asking for treatment, for dealing with emergency care, for supporting others. It had safe spaces for parents, partners, carers to socialise. It had diary threads you could post in and read, if you were well enough, and those diaries came by convention with warnings about the content. If you didn’t want to engage with the illnesses of others, for fear of worsening your own, you did not have to.

Words cannot express how valuable trigger warnings were to me, or to many of the other users on BUS. Not just those with PTSD, or anxiety disorders, or specific trauma-related illnesses; not even just those who self-harmed or those with eating disorders; all of us who used that space benefitted from its policies on keeping us safe.

Trigger warnings on the web were born in communities trying to balance the need to speak with the need not to hear. Those communities were closed, or at least only partially open; LiveJournal communities where membership rules could be enforced, forums and BBs where mods had control over members’ posts. Trigger warnings do not translate well to public spaces – Tumblr tags, Twitter, even Facebook groups, or some of the real-life scenarios mentioned in the New Review article – because those needs are different for the wider community. Interestingly, some Tumblr tags do take content warnings well – conventions have grown up around those tags, and those who transgress those conventions are essentially moderated out by the existing users. But there’s no system to support that, nothing to stop a sustained invasion, no way to organise that space to support that use.

But just as it is inadvisable to add trigger warnings to everything based on the possibility of harm, it’s just as inadvisable to remove them from everything based on disbelief in their effectiveness. In communities focussed on mental health and recovery, trigger warnings are absolutely necessary for users. Whether college classes, campuses or the Huffington Post need the same level of consideration is a valid question, for sure, but it’s one worth asking. If you want people with disabilities to be able to participate fully in your spaces, you’d better be thinking about accessibility in terms of triggers and mental wellbeing as well as wheelchair ramps and sign language. And that doesn’t always need to be in formal language: sometimes it’s as simple as editing a tweeted headline to include the word ‘distressing’, to give your followers the choice about what they click on.

The New Review piece concludes:

Trigger warnings are presented as a gesture of empathy, but the irony is they lead only to more solipsism, an over-preoccupation with one’s own feelings—much to the detriment of society as a whole. Structuring public life around the most fragile personal sensitivities will only restrict all of our horizons. Engaging with ideas involves risk, and slapping warnings on them only undermines the principle of intellectual exploration. We cannot anticipate every potential trigger—the world, like the Internet, is too large and unwieldy. But even if we could, why would we want to? Bending the world to accommodate our personal frailties does not help us overcome them.

There is no way to stop every vulnerable person from coming across things that will make them more vulnerable. There is, however, courtesy and consideration, and a need for equal access for those with mental health issues. Those are not small things. There is a valuable, important baby being thrown out with this bathwater.

This will be the mantra of your coming years. This will be what guides you, what gets you up in the morning and gets you to sleep, eventually, late at night. This will be the phrase you cut out of newspaper letters and paste on your walls in seven different places you call home. This will be the only thing you believe without empirical evidence, not because it is pleasant but because you have already seen the alternative, where it was worse, and that is no longer an option.

It gets better.

You will crawl out of the hell of the depression you live in now. You will eventually discover other ways to contain the fire inside you that has you tearing at yourself. You will learn to name your emotions, and you will learn that they cannot, must not, be excised. You will learn to budget, to cook, to clean. You will find yourself laughing from time to time. Between the drama, somehow, you will pass exams.

It gets better.

You will leave the shattered remnants of your teenage years and flee to a new city, where you will fall in love, and out of love, and in love again more permanently. You will discover talents, and interests, and the Cow Tower on the river bend. You will learn to think in systems as well as stories. You will not sleep, until eventually the nightmares recede. You will learn to eat. You will learn to work. You will learn that you are valuable and worthy of respect. You will sometimes believe it.

It gets better.

You will move. You will grow. You will find London and, within it, friends. You will make things – games, poems, stories. You will smile almost every day. You will no longer need to make lists of what is good in the world. You will know it in your bones. You will work well in a job that makes you happy. You will play well in a world that makes you happy. You will create muscles where once was skin and bone. You will still have bad days, but they will be rare and nowhere near as bad as they once were. You will fly half way around the world and a lorikeet will crash into your window.

But first, before it gets better, it gets worse.

You will decide there is no purpose, no future, nothing of worth to you, and you will try to destroy yourself. You will not succeed. You will see out the millennium with a glass of fake champagne in an NHS medium-security ward, a nurse at arm’s length. There will not be fireworks. You will get birthday cards from the other patients. You will punch walls until your fists bleed. You will lie on the carpet and not make your bed and only emerge from your room for coffee. You will not take your hat off for five months. But slowly, you will take your first steps toward believing what I now know to be true.

It gets better.

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The night before my parents arrive, I almost do not go out for dinner. At midday I send the email I dread sending but that seems to be required regardless, at regular intervals: hello, I am a little mad today and may be unable to participate in our scheduled social interaction.

Those emails don’t really get easier to write. Every time it is a disappointment. It means I tend not to commit to seeing people, because I would rather avoid the shame and stress of pulling out, admitting in front of friends that yes, I am still mad, I am not better yet and I may never be, even though I do what I do and I seem so terribly together and efficient, and so on. It is still galling. There is still shame. I still hate letting people down. So I send the email just in case, because cancelling six hours ahead is better than one, if I don’t improve.

In the end I go out, but not before a minor emotional meltdown in the street after I leave the office. Grant holds my shoulders and reassures me the world is not an awful place. I take a deep breath or three and board a train and then I am committed, and in the end it is an excellent evening and I am not too mad after all.

—

I am up to my waist in sea water and Grant is standing in front of me, holding my shoulders, reminding me that the world is not an awful place. We can see the beach from the villa we have taken for a week just north of Cairns, just past Deadman’s Gully nature reserve, past the signs that warn of crocodiles and the pole full of vinegar in case of marine stingers. There is a white-bounded net that bobs up and down on the water and, in theory, keeps out the monsters that might twine tentacles around your legs and hurt you. The water is thick with sand and I cannot see my feet below the surface. Grant is in front of me and I take one step at a time, deeper into the water. Eddies swirl around my knees.

The panic hits me in waves. Thick clotting brain-scrambling panic, the sort that makes you strike out for shore and say cruel things to make the fear end, followed by lulls of maybe-time. Waves of no — no — no — I cannot, then it eases into a chorus of well — perhaps. I can imagine myself leaving the house. I can picture myself dressed, opening a door. If I can imagine that much perhaps — perhaps I can be a normal human being for a night. I can imagine myself swimming in this warm, cloudy water under such astonishing sky. I can.

The lull occurs. I say: “Follow me. Now. Before I change my mind.” And I turn towards the far edge of the net and I swim. Powered by panic and perseverance I kick harder and faster than he can keep up with, and I make it out to the net, a monstrous thing that catches at my legs but that I am expecting and so do not scream about. I turn and I make for shore as the panic begins to rise again, catching a wave and putting my legs under myself and striding out of the sea.

—

The water off Green Island is clear blue and warm in the morning. It takes me a few tries to successfully breathe through the snorkel, as I keep holding my breath and expecting to drown. Then I manage, eventually, to duck down and hold myself steady, kicking slowly and gliding through water clear as air, parting a shoal of fish the size of my palm that kick alongside me out to the deeper water. Grant calls me over and shows me a hermit crab, scuttling along the bottom; there are big broad fish in ones and twos. I am thinking: this is pretty awesome, all these fish right here.

Then we go deeper, out to one of the dark patches that litter the sea floor. First it is seaweed and a few scattered fish, then suddenly it is like flying over a forest. There are more fish than I can see in one go. I have to compartmentalise, looking first at things on one side and then on the other, else I will miss something. Yellow and black, orange and blue. An electric blue starfish the size of my arm. Beneath it all, the coral: branches and balls, limestone structures built for monsters to live in. When we swim to shore Grant chases a manta ray between the waves.

In the afternoon, though, the water is deeper. Colder. Currents rush across our bodies, eddy around my knees. A raft of seaweed floats on top of the waves, which are bigger now, clouding the water and making it harder to see. I get frightened. I stop trusting my body to carry me and I stop trusting the sea. Soon I am struggling with my snorkel, because hyperventilating through a tube underwater is even more problematic than doing it on dry land. I make it out to the coral but I am scared of the seaweed clinging to me and dragging at my skin. I try but I do not succeed in seeing much else of wonder; I am too afraid. Grant holds my shoulders and I cling to him in the water, scared of moving, scared of not moving, willing myself suddenly to become able to teleport or levitate or simply not feel this ridiculous rushing chaotic gut-wrenching panic any more. Eventually I am just saying the word “phobia” over and over into my snorkel as though by naming it I will be able to make it stop. We decide to swim back for shore.

And then there it is. I duck my head under the waves and there it is: a turtle the size of Grant’s torso, perhaps a metre below me, sculling one fin at a time out to sea. I make the sort of strangled yelping noise that generally denotes drowning but manage to signal to Grant that, no, I’m OK, but look: turtle. TURTLE. Through a snorkel, I explain. And we turn tail together and, holding each other in sight, we follow the turtle. We swim back out into deep water, through the mass of surface seaweed I could not break before. I am terrified, but the turtle is more important. We follow and follow until looming out of the dark water beneath there is another turtle, treading water, patiently waiting, and the two of them together slowly, gracefully paddle their way out to sea.

Yesterday I went swimming for the first time in months, and managed half a kilometre before work. Tomorrow I’m planning to go and attempt to work out in a hot room, for an hour and a half, at my first bikram yoga class. I’m looking forward to it. This is new to me.

I have not been strong for long. I came late to the idea of exercise as something you might do because you enjoy it, rather than because someone was forcing you to. I was a child more brain than body, more eyes than hands. Eczema played a part in my reticence to touch the world: when water can hurt you and your skin is always cracked and broken, roughing your hands in the dirt is something simply not done. I did not do handstands or climb trees. I read books instead.

Then in my teens, I weakened my own body in order to gather the mental fortitude I needed to fight the depression. First, for a time, my legs simply stopped working, as though the depression was starting at the bottom and working its way slowly upwards. By the time it took hold of my brain I was routinely tearing at myself in awful ways. I failed to eat enough to let myself grow after the age of 13. I walked dizzy with shock and blood loss, combined with lack of food. For years my body was a battleground: a warzone, an adversary and collateral damage, all at once. Perhaps if you take strength as a measure of what a body is capable of withstanding, rather than what it is capable of achieving, I have always been strong.

But this actual, physical ability is relatively new. 18 months ago, a little more, I decided at Christmas that I wanted to be a ninja. That I was fed up of hiding and of being incapable of moving, that I wanted not to be a different shape or size or weight but to be able to do different things with my body. To be less limited. Since I was young I have escaped into game worlds, taking particular pleasure in those that afforded me freedom of movement: Morrowind’s grand vistas and levitation spoke to me, but better were Assassin’s Creed and Prototype. To run up buildings and fly free. To be unlimited by flesh. I didn’t want to be full of virus or to knife people in the back, but to glide like a squirrel between tall towers or swan dive unharmed into haystacks.

I took up parkour for a while and was terrible at it, had to stop learning because of logistical problems, but carried on strength training at home. When I started I couldn’t do one push-up. Now I can knock them out without much effort. It has not been an overnight change, but it still feels sudden sometimes. I still cannot run up buildings. Today yoga, and perhaps next week I will try parkour again and see how bruised it leaves me.

I’ve spent a lot of life escaping from my body, seeing it as a limiting factor, hating its needs and changes, fighting it for control. Finally I’m coming to see it as me. I inhabit its corners now in a way I couldn’t have imagined a few years ago. I will always be bookish, more eyes than hands, but now I am no longer afraid to touch.

Depression sneaks up on me around this time of year. Most years I spend these late months down, though some more so than others. There’s something about the slow dying of the light that brings out the noonday demon, bleaching colour from the day and bringing sharp edges to the night.

Though that’s too poetic, really, for the drab reality. Sleepless nights followed by nights of too much sleep, leaving me drained and exhausted regardless. Headaches that don’t leave, restlessness without cause, and sadness that turns up unexpectedly mid-sentence and refuses to dissipate. Most of all, a thin veil that descends between me and the world, dulling joy and blunting emotions, making it hard to participate through the feeling of awful apart-ness, as though I’m watching life on a screen and not participating. In the summer I take on dozens of projects, safe in the boundless energy the light brings. In winter, I count spoons and mete out activity in careful, measured portions, for fear of failing to cope. Without Grant, I would struggle to eat well or sleep at all.

For some people – I’m one of them – depression is just a fact of life. I don’t remember a time before depression. I guess I was 11 when I had my first full-blown episode; I know I was 12 when I was first diagnosed. I know what it’s like to be happy, but I don’t know what it’s like not to have to hoard it, guard it, trace its contours for as long as I possess it. To not know with certainty that it is fleeting, and must pass.

That is one of the cruellest things about this illness. It perpetuates itself in the knowledge of itself. Depression is itself depressing. And terribly boring, too. So many depressives – myself included – develop other problems in part to cope with the bleakness of the dark mornings, but also because they are at least something that can be controlled, and that brings an upside, a dramatic, vivid illustration of the pain we’re in, and something else to focus on. Perhaps it’s taboo to suggest that anorexia, alcoholism, self-injury and so forth have benefits, but it’s true; otherwise, they wouldn’t be so seductive. I recall vividly a psychiatrist telling me that if they could bottle and prescribe the psychological effects of self-harm without the messy reality, it would be the most effective antidepressant ever – and one of the most addictive.

So in the down times I cope not only with the depression itself but also with the desperate animal-in-trap desire to hurt myself, something counterproductive, self-destructive but also self-preservative, something that – if I could control it and mitigate its down sides – would be the best possible way of dealing with the depression. That, I think, makes it harder – to know, intimately, that there is an easy option, and still not to take it.

But then, this too shall pass. The most powerful knowledge I have is that this will pass. It must pass. The blackness is not permanent; the sun will rise again. What I fear most is forgetting that such sadness is temporary. That way lies madness.

This post was imported from my Tumblr as part of a big reorganisation of my online self in January 2012.